Euthanasia: are we ready for it?
Consider this. You’re diagnosed with a terminal illness. Certain death awaits you: no hope, no future. All you can look forward to is pain and death.
You have two options: either bear through the pain until you die, or have your doctor inject chocolate into your veins until it kills you – without pain, I might add.
I would choose death by chocolate. Which option would you choose?
If you answered the question, you just wasted your energy. You actually don’t have a choice: the only option is to bear through the pain until you die.
Euthanasia – or assisted death by choice to end pain and suffering – is illegal in many countries; including Australia. There’s a huge ethical dilemma surrounding euthanasia, making it a difficult topic to tackle. But by observing countries where euthanasia is legal, we can see what it’s actually like.
Among the very few places where euthanasia became legal, Belgium and Netherlands stand out as having the longest history and experience. This makes them a good model for other countries to decide on whether they should legalize euthanasia. So, what do we see in these countries- namely, Belgium?
What happens with Euthanasia?
Among the reasons for granting euthanasia, patient’s request is considered the foremost important factor. Physical and/or mental suffering, and no prospect of improvement are regarded as crucial in making such a decision. These are quite reasonable and well-defined criteria, which result in good outcomes.
Doctors observed family members’ grieving processes being more serene when they’re able to say their goodbyes: which they are able to do with euthanasia. They’re appreciative of the doctor’s decisions, even if they had prior uncertainties. From the standpoint of the patients who chose euthanasia, there are also benefits.
First, many of the patients whose requests are accepted have very little time to live. So there isn’t a huge impact on their lifespan. Second, there are psychological benefits which come with acceptance and control over death, such as: reduced anxiety, more appreciation of remaining life, a higher sense of spiritual accomplishment. Third, there were cases in which patients accepted treatment only on condition that its failure would be followed with euthanasia. It’s been reported, in one such case, the treatment having added almost a year to the lifespan of the patient.
Acceptance of euthanasia in Belgium has increased quite considerably since its introduction in 2002. Doctors are more confident in their decisions, and terminally-ill patients are more open to euthanasia. In view of all these, what are the concerns preventing other countries from adapting such a system?
Why are some people against Euthanasia?
“Slippery-slope” is the term that’s used. Once you introduce euthanasia to a certain group of people (i.e. the terminally ill), it may become accepted to the point where the law will have to expand to include more people. The terms ‘unbearable suffering’, and ‘dying’ – which are subjective terms- could become more and more lax; to the point where it includes people who could benefit from living. Therefore, the main concern surrounding euthanasia is that it could lead to unnecessary death. Although there are safeguards put in place to prevent such events, many remain speculative about their effectiveness.
A case of Euthanasia.
Allow me to finish up with a case-scenario. Identical twins, Mark and Eddy Verbessem, were both born deaf. They lived together their entire life, unmarried, and working as shoemakers in a small village in Belgium. As they neared 45 years of age, they were diagnosed with glaucoma- which would inevitably lead to complete blindness. As their only means of communication was sign language, blindness would cause them to be unable to communicate with each other. They would need to be institutionalized, and won’t be able to see each other. This was unbearable for the twins. They were already worn out with other medical problems from their labor intensive job. So, they requested euthanasia. They were aware that many people were living death and blind, but they had nothing to live for. Would you accept their request?
Spoiler alert: Their initial request was rejected, but after two years, it was accepted. The doctor believed that the psychological suffering was severe enough to justify euthanasia, but acknowledged that others may have different views than him.
The Belgian model continues to evolve; as it still has imperfections for which solutions are being developed. However, it is assuring to know that euthanasia in Belgium has received positivity among Belgians since 2002: as Belgians’ confidence in their health care system rose to second-highest in Europe. Other countries will definitely keep observing and learning from Belgium and who knows- one day, it may become just another normal medical procedure.
Want to learn more? “Questions and Answers on the Belgian Model of Integral End-of-Life Care: Experiment? Prototype?“, is a great article by Jan Bernheim, Wim Distelmans, and Arsene Mullie. They are doctors and researchers who have had first hand experience with palliative care in Belgium.
Note: There is actually no ‘medical’ way of death by chocolate. It is not used as a euthanasia, so don’t get your hopes up.
Edit: For those interested in ethics of difficult topics as such, Nelson has recommended a book called “Practical Ethics” by Peter Singer.
Edit2: For those interested in euthanasia, Tal has recommended a podcast called “Better Off Dead” by Andrew Denton.